COMPARISON OF PREGABLIN VERSUS PLACEBO FOR POSTOPERATIVE PAIN IN PATIENTS UNDERGOING LOWER LIMB SURGERY
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Keywords
Postoperative pain, Lower limb surgery of Tibia/femur, Opioids, pregablin
Abstract
Objectives: To compare the postoperative outcomes of pregablin versus placebo in patients undergoing Lower limb surgery.
Materials and Methods: In this RCT study, we enrolled a total of 100 patients, undergoing elective lower limb surgery of Tibia/femur. Patients were divided into two groups. Group I was offered Pregablin and Group II was given Placebo. Pain was assessed on VAS scale and at 2 score 4 and above IV pethidine 50 mg was given. At 24 hours pain was assessed finally and consumption of opioid was noted in the proforma by the PI.
Results: The average age of the patients was 39.08±8.81years. Mean pain score was significantly high in group II than Group I [4.7±1.39 vs. 2.52±0.99; p=0.0005]. Mean Opioid consumption was significantly high in group II as compare to group I [91.22±42.92 vs. 55.56±16.67; p=0.019].
Conclusion: Administering a single preoperative oral dose of 150 mg pregabalin has been demonstrated as an effective approach in mitigating postoperative pain among individuals undergoing lower limb surgery.
References
2. Miller RD, Eriksson L, Fleisher L, Wiener-Kronish J, Young W. Miller's Anesthesia, 2010. Churchil Livingstone, Elsevir Inc, Philadelphia, PA. 1703.
3. Joshi GP, Kehlet H. Postoperative pain management in the era of ERAS: an overview. Best Practice & Research Clinical Anaesthesiology. 2019;33(3):259-67.
4. Bansal A, Tewari A, Garg S, Gupta A. Pregabalin: Pharmacology and use in pain management. Journal of Anaesthesiology Clinical Pharmacology. 2009;25(3):321-6.
5. Sills GJ. The mechanisms of action of gabapentin and pregabalin. Current opinion in pharmacology. 2006;6(1):108-13.
6. Jabari Moghadam M. Comparison of the effect of gabapentin with pregabalin in post dural puncture headache. J Iran Soc Anesthesiol Intensive Care. 2010;31:1-6.
7. Damirchi AN, Kamali A, Azami M, Monfared ME. Comparison of the effect of apotel and pregabalin on postoperative pain among patients undergoing lower limb orthopedic surgeries. Journal of Family Medicine and Primary Care. 2019;8(7):2405-8.
8. Choudhury B, Pathak DG, Chauhan RC, Singha LC, Mondal D. Effect of intrathecal nalbuphine and magnesium sulphate used as adjuvants with bupivacaine in spinal anaesthesia for lower abdominal surgery: a comparison. Group. 2016;1000(50):43.72.
9. Ghai A, Gupta M, Hooda S, Singla D, Wadhera R. A randomized controlled trial to compare pregabalin with gabapentin for postoperative pain in abdominal hysterectomy. Saudi journal of anaesthesia. 2011;5(3):252-7.
10. Rowbotham M, Harden N, Stacey B, Bernstein P, Magnus-Miller L, Group GPNS, et al. Gabapentin for the treatment of postherpetic neuralgia: a randomized controlled trial. Jama. 1998;280(21):1837-42.
11. Backonja M, Beydoun A, Edwards KR, Schwartz SL, Fonseca V, Hes M, et al. Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus: a randomized controlled trial. Jama. 1998;280(21):1831-6.
12. Magnus L. Nonepileptic uses of gabapentin. Epilepsia. 1999;40:s66-s72.
13. Caraceni A, Zecca E, Martini C, De Conno F. Gabapentin as an adjuvant to opioid analgesia for neuropathic cancer pain. Journal of pain and symptom management. 1999;17(6):441-5.
14. Mellick GA, Mellick LB. Gabapentin in the management of reflex sympathetic dystrophy. Journal of pain and symptom management. 1995;4(10):265-6.
15. Bafna U, Rajarajeshwaran K, Khandelwal M, Verma AP. A comparison of effect of preemptive use of oral gabapentin and pregabalin for acute post-operative pain after surgery under spinal anesthesia. Journal of Anaesthesiology Clinical Pharmacology. 2014;30(3):373-7.
16. Alimian M, Imani F, Hassani V, Rahimzadeh P, Sharifian M, Safari S. Effects of single-dose pregabalin on postoperative pain in dacryocystorhinostomy surgery. Anesthesiology and pain medicine. 2012;2(2):72.
17. Akhavanakbari G, Entezariasl M, Isazadehfar K, Mirzarahimi T. The effects of oral pregabalin on post-operative pain of lower limb orthopedic surgery: a double-blind, placebo-controlled trial. Perspectives in clinical research. 2013;4(3):165-8.
18. Trivedi PA, Mehta M, Trivedi J. Pre emptive gabapentin versus pregabalin for post operative analgesia after abdominal hysterectomy under spinal anaesthesia. Int J Res Med. 2015;4(1):53-8.
19. Eman A, Bilir A, Beyaz SG. The effects of preoperative pregabalin on postoperative analgesia and morphine consumption after abdominal hysterectomy. Acta Med Mediterr. 2014;30(2):481-5.
20. Jokela R, Ahonen J, Tallgren M, Haanpää M, Korttila K. Premedication with pregabalin 75 or 150 mg with ibuprofen to control pain after day-case gynaecological laparoscopic surgery. British journal of anaesthesia. 2008;100(6):834-40.
21. Agarwal A, Gautam S, Gupta D, Agarwal S, Singh P, Singh U. Evaluation of a single preoperative dose of pregabalin for attenuation of postoperative pain after laparoscopic cholecystectomy. British journal of anaesthesia. 2008;101(5):700-4.
22. Jokela R, Ahonen J, Tallgren M, Haanpää M, Korttila K. A randomized controlled trial of perioperative administration of pregabalin for pain after laparoscopic hysterectomy. Pain. 2008;134(1-2):106-12.
23. Hill CM, Balkenohl M, Thomas DW, Walker R, Mathe H, Murray G. Pregabalin in patients with postoperative dental pain. European Journal of Pain. 2001;5(2):119-24.
24. Cabrera Schulmeyer MC, de la Maza J, Ovalle C, Farias C, Vives I. Analgesic effects of a single preoperative dose of pregabalin after laparoscopic sleeve gastrectomy. Obesity surgery. 2010;20:1678-81.
25. Paech MJ, Goy R, Chua S, Scott K, Christmas T, Doherty DA. A randomized, placebo-controlled trial of preoperative oral pregabalin for postoperative pain relief after minor gynecological surgery. Anesthesia & Analgesia. 2007;105(5):1449-53.
26. Mathiesen O, Rasmussen M, Dierking G, Lech K, Hilsted KL, Fomsgaard J, et al. Pregabalin and dexamethasone in combination with paracetamol for postoperative pain control after abdominal hysterectomy. A randomized clinical trial. Acta Anaesthesiologica Scandinavica. 2009;53(2):227-35.
27. Zhang J, Ho K-Y, Wang Y. Efficacy of pregabalin in acute postoperative pain: a meta-analysis. British journal of anaesthesia. 2011;106(4):454-62.
28. Post ZD, Restrepo C, Kahl LK, van de Leur T, Purtill JJ, Hozack WJ. A prospective evaluation of 2 different pain management protocols for total hip arthroplasty. The Journal of arthroplasty. 2010;25(3):410-5.
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Dr Mamoona Shaikh
Assistant Professor, Anaesthesia Department, LUMHS, Jamshoro, Pakistan
Dr Maria Karim Narejo
Medical Officer, MCPS Anaesthesiology, Anesthesia Department, LUMHS Jamshoro, Pakistan
Dr Jamil Ahmed
Associate Professor Anaesthesiology Isra University Hospital Hyderabad, Pakistan
Dr Kauser Shaikh
General Surgeon Shah Bhittai Hospital Hyderabad, Pakistan